The epidemiology of scaphoid fractures has been described in limited populations, and incidence reports have been inconsistent. We investigated the nationwide incidence of scaphoid fractures by evaluating data on 34,377 patients in the Swedish National Patient Register for the years 2006–2015 regarding diagnosis, age, sex and treatment. The data were validated in 300 random patients, and incidence rates were adjusted accordingly. Forty-one per cent of the initially diagnosed fractures were false positives. The adjusted true fracture incidence rate was 22 per 100,000 person-years. During the decade studied incidence rates decreased in younger men and increased in middle-aged women. The incidence of surgical treatment vs. non-operative treatment did not change over time. Men were treated surgically more often than women (6% vs. 3%) and had a greater risk for nonunion (3% vs. 1%).

Purpose: Lunocapitate arthrodesis is a motion-preserving salvage procedure for painful wrist osteoarthritis. Because the arthrodesis is limited to the capitate and the lunate, the adaptive motion of the triquetrum is theoretically maintained. We aimed to examine whether triquetral motion is sustained in vivo after lunocapitate arthrodesis. Methods: We examined 7 patients after lunocapitate arthrodesis at least 1 year earlier, with computed tomography at 2 wrist positions: maximal radial extension and maximal ulnar flexion. Triquetral motion in vivo was analyzed using volume registration technique of the paired computed tomography scans and compared with the contralateral side. Results: The triquetrum moved in all patients, but the degree of motion was small compared with the nonsurgical wrist. A minor degree of motion of the hamate relative to the fused lunocapitate could also be demonstrated. Conclusions: Triquetral motion is limited after lunocapitate arthrodesis. Type of study/level of evidence: Therapeutic IV.

The clinical implication of a residual flexion deformity following surgery for scaphoid nonunion is unclear. Sixty-three patients who underwent scaphoid nonunion surgery were assessed after a mean of 7 years (range 5–10) to analyse the outcomes based on the presence of residual scaphoid deformity. Primary outcome was Disabilities of the Arm, Shoulder and Hand score. Secondary outcomes were Patient-Rated Wrist Evaluation score, wrist range of motion and strength. Patients were dichotomized to residual deformity or no deformity. Scaphoid deformity was calculated from CT scans based on the median difference between the height–length ratio of the operated versus the uninjured scaphoid. There were no differences between residual deformity ( n = 33) and no deformity ( n = 30) in any outcome variables, except for wrist extension which was slightly worse in the deformity group. The deformity group had a greater number of radiographic osteoarthritis, but all cases were mild, and osteoarthritis did not correlate to a worse outcome. We conclude that residual scaphoid deformity has no relevant negative impact on mid-term wrist function. Level of evidence: IV